• Miqdad Haider Fatima Memorial Hospital, Lahore
  • Aijaz Zeeshan Khan Chachar Fatima Memorial Hospital, Lahore
  • Atif Munir Fatima Memorial Hospital, Lahore


Thyrotoxic periodic paralysis is an uncommon disorder characterized by hypokalaemia, thyrotoxicosis and paralysis, most commonly seen in South Asian males. Aim of our case series is to highlight the significance of this reversible cause of patients presenting with neuromuscular paralysis. We present case series of 1 Asian and three Caucasian patients with thyrotoxic periodic paralysis who came with neuromuscular weakness secondary to thyrotoxicosis. All made a swift and uneventful recovery with no recurrence. Thyrotoxic periodic paralysis (TPP) is an infrequent condition having recurrent episodes of muscle weakness as main feature. Hypokalaemia is a common finding seen in these patients. Resolution of the attacks is achieved with correction of hypokalaemia and hyperthyroidism.Keywords: Hyperthyroidism; Thyrotoxic periodic paralysis; Hypokalaemia; Paraparesis


Lam L, Nair RJ, Tingle L. Thyrotoxic periodic paralysis. Proc (Bayl Univ Med Cent) 2006;19(2):126–9.

Lin SH, Huang CL. Mechanism of thyrotoxic periodic paralysis. J Am Soc Nephrol 2012;23(6):985–8.

Ali Chaudhry M, Wayangankar S. Thyrotoxic Periodic Paralysis: A Concise Review of the Literature. Curr Rheumatol Rev 2016;12(3):190–4.

Ahlawat SK, Sachdev A. Hypokalaemic paralysis. Postgrad Med J 1999;75(882):193–7.

Liu YC, Tsai WS, Chau T, Lin SH. Acute hypercapnic respiratory failure due to thyrotoxic periodic paralysis. Am J Med Sci 2004;327(5):264–7.

Lichtstein DM, Arteaga RB. Rhabdomyolysis associated with hyperthyroidism. Am J Med Sci 2006;332(2):103–5.

Magsino CH Jr, Ryan AJ Jr. Thyrotoxic periodic paralysis. South Med J 2000;93(10):996–1003.

Kornø MR, Hagen C. Hypokalemic thyrotoxic periodic paralysis--a rare differential diagnosis in patients presenting acute tetraparesis. Ugeskr Laeger 2008;170(39):3070.

Siddiqui FA, Sheikh A. Muscle paralysis in thyrotoxicosis. BMJ Case Rep 2015;2015:bcr2014207945.

Venance SL, Cannon SC, Fialho D, Fontaine B, Hanna MG, Ptacek LJ, et al. The primary periodic paralyses: diagnosis, pathogenesis and treatment. Brain 2005;129(Pt 1):8–17.